Tuesday, November 3, 2009

Yesterday, I had surgery at Stroger Hospital. My appointment was for 6:30 a.m. But the hospital was so overwhelmed that didn't get my operation until after 5 p.m.

I spent the whole day lying on a gurney in the pre-op area. Afterward, I was in terrible pain they were unable to get controlled, but they still sent me home because — the nurse said — there were patients in even worse shape that they didn't have beds for.

Our health care system is under attack! Our hospitals and clinics which serve over 80% poor, black, latino and immigrant people are being dismantled. If we don't fight back against these attacks the patients served with be left without healthcare.

Where will we go when we get sick and can’t afford the $10-$50 dollar co-pays per clinicvisit?! What clinics will we go to when they become run by the federal government and bill for their services? Where will we get our medicines when our pharmacies are eliminated because our clinics are sold off? What hospital will we go to when the in-patient services areeliminated?

This is what CEO Foley and the new governing board is proposing. Already over 300 nurses, doctors and medical staff have received lay off notices and there are still more to come! Everyattack on our health care workers and our hospitals and clinics is ultimately an attack on us.

We cannot remain silent! We have got to fight back. THESE ARE THE PROPOSED CUTS:

Eliminate all of inpatient care at Provident Hospital!

Eliminate all of inpatient care at Oak Forest Hospital!

Close more ACHN clinics and turn others like Robbins Community Clinic and Cottage Grove into Federally Qualified Health Centers(FQHC's)!

I don't know who the brave individuals who let themselves be arrested were, but they have my profound gratitude. All I know is that they represent the Illinois Single Payer Coalition, the Chicago Single Payer Action Network, Progressive Democrats of America and Physicians for a National Health Care Program.

No news media troubled to report the names of those arrested. AP did a short item on the story, which is all the Chicago Tribune ran. No other mainstream Chicago media covered it at all, so far as I can tell.

"And we will stand with you, as you have stood with us," wrote the Sun-Times today, announcing its new owners. I'm glad the paper will survive.

Tuesday, August 11, 2009

I was shocked and saddened to hear of the death of 27-year-old Nicholas Skala. Mr. Skala, who died suddenly of unknown causes in his Chicago home last weekend, was one of the most dedicated campaigners on behalf of single-payer health care. His death is a terrible loss to the movement.

A one-time staff member of Physicians for a National Health Program, Mr. Skala continued to work for the cause as a volunteer even after he had left the organization to go to law school. He was a dedicated and talented advocate.

Dr. Ida Hellander, executive director of PHNP, wrote:

"His incisive mind, wide-ranging knowledge and formidable skills of argument were devoted entirely to bringing about a better world for everyone.

"To his friends and co-workers, he was an extremely witty and compassionate human being, and a great source of inspiration and encouragement.

"Nick had only recently returned to Chicago from two months in Washington, D.C., where he contributed significantly to the cause of single-payer health reform in multiple ways. He was committed to working for PNHP in our Chicago office during the next six weeks prior to his return to his classes at Northwestern University Law School.

"His death is a heavy blow to our organization and to the entire single-payer movement.

"We vow to redouble our efforts to bring about Nick Skala's vision."

I never met Nick Skala or spoke to him, but we exchanged e-mail on several occasions. He was unfailingly polite, interested and prompt in his replies to a random blogger, which made him nearly unique in my experience of trying to communicate with local health-care reformers.

I express my sincere condolences to Mr. Skala's family and friends, to his colleagues at PNHP, to the single-payer cause in general and to society as a whole. We are all poorer for the loss of such a promising young man.

A funeral service for Nicholas Skala will be held at 7:30 p.m. Thursday, Aug. 13, at the Lauterburg-Oehler Funeral Home, 2000 E. Northwest Highway, Arlington Heights. Visitation will take place from 3 p.m. to 7:30 p.m.

According to PHNP, Mr. Skala's parents, Judith and Ronald Skala, have invited all of his friends to attend, and ask that, in lieu of flowers, contributions in his memory be made to Physicians for a National Health Program, 29 E. Madison St., Suite 602, Chicago, IL 60602.

Sympathy cards can be sent to Judith and Ronald Skala, 12215 Lakewood Glen Ct., Cypress, TX 77429. Condolence messages sent to PNHP or the funeral home will be forwarded to the family.

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

Palin seems to be confusing Obama's plan with our current system in which a "death panel" of insurance-company bureaucrats decides who's worthy of health care based on what will generate the most profits, and anyone who's so unproductive as to be sick and out of a job may as well curl up and die. That's the evil America Sarah Palin knows and loves!

Please note that this isn't coming from some wacko fringe element of the Republican Party. This is coming from a woman whom the party seriously considered suitable to be second-in-command to the leader of the free world.

U.S. ballplayers threaten strike if health-care reform isn't passed before the World Series. "Some things are more important than baseball," sluggers say.

Rush Limbaugh says he's now supporting H.R. 676.

Staffers sorting George W. Bush's cast-offs in the White House basement have discovered a huge cache of gold and platinum. The administration says there's enough there to fund heath care for all American for 20 years. The deposit was labeled "Weapons of Mass Destruction."

Monday, August 3, 2009

Dr. David Scheiner, who was Pres. Barack Obama's personal physician for 22 years, until Obama went into the White House, speaks out forcefully for single-payer health care in this video, and he is no fan of the president's plan, or that of those that were being hashed out in the House and Senate, before those legislators gave up and went on vacation. (About 1,800 Americans will die as for lack of health care during the August recess, but what does Congress care?)

"If I had a single point to make about what is going wrong with this health reform is that the public is so uniformed. They think somehow that they get the best care in the world. We know by health statistics we're 37th. Even people with good health insurance don't realize that the health care they get is often not appropriate...."

He's right. And most people haven't a clue as to what "single payer" means.

While single-payer is getting a little more attention at last, it's extremely interesting to see that Scheiner was dis-invited from the recent White House press conference on health-care reform. (I don't supposed that mattered much to the cause of single-payer, since everything that was said at that event was immediately swallowed up in the furor after Chicago Sun-Times Bureau Chief Lynn Sweet asked about Skip Gates.)

I would very much like to know whether the impetus came from Pres. "Small Change" Obama's side or from ABC's.

Journalism is not covering the issue of health-care reform well. I agree with Maggie Mahar: Tbe media are not giving the public the information they need in order to understand all of the sides of this issue, and is failing in their critical role of analysis.

Saturday, August 1, 2009

I feel a little more hopeful about health-care reform today. It looks as if progressives in Congress may be finally waking up from the dead.

New York Rep. Anthony Weiner's move to showcase the hypocrisy of conservative House members on government-run health care was hilarious. He proposed to eliminate Medicare. Of course, not a single congressman voted for it.

House Speaker Nancy Pelosi's strong language painting insurance companies as villains was good to hear.

It also sounds as if House Rep. Barney Frank (D-Mass.) thinks the Blue Dog Democrats can be brought to heel on a public option. In a letter to constituents, Frank wrote:

I am a strong supporter of single payer, and I do reluctantly accept a full public option as the best we can do. So I am strongly committed to a public option and I will not vote for a bill that does not include a nationwide, genuine public plan.

Meanwhile, 57 members of Congress have signed a letter saying, "Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates — not negotiated rates — is unacceptable," and promising not to vote for the Blue Dog "compromise" bill currently on the table.

Signers include Illinois congressmen Luis Gutierrez (D-4th), Phil Hare (D-17th) and Jesse Jackson, Jr. (D-2nd). I'm deeply disappointed not to see the names Danny Davis (D-7th), Bobby Rush (D-1st) and Jan Schakowsky (D-9th) on this list. If your representative's name isn't there, urge him or her to take the pledge.

While you're at it, send a note to Pres. Onamby-pamby urging him to promise he won't to sign any bill without at least a strong public option. Remind him that when we voted for change, we didn't mean small change. Tell him you want real change, like the single-payer option he used to say he supported.

There's also hopeful news on single-payer, perhaps. In order to get Weiner to withdraw his amendment to replace the House Energy & Commerce Committee's bill with the single-payer H.R. 676, Committee Chairman Henry Waxman (D-Calif.) said that he had spoken with Pelosi, and she had pledged that single-payer would get a debate and floor vote and a debate on single payer in the full House! I'll believe it when I see it, but if it turns out to have been a mere ploy to get Weiner to shut up, Waxman is going to be up against the wall when the revolution comes.

Thursday, July 30, 2009

I haven't posted in a while. I've been feeling worse again, and I've been depressed over the way that health-care reform is going. I'm becoming convinced that if anything passes at all, it's going to be so watered down as to be useless, or make matters even worse. And I don't see that any of the plans now being bruited in Congress are going to be any help to me at all.

However, if anyone's still checking in, I wanted to draw your attention to Ellen Beth Gill's post from yesterday. She really said everything I feel about the current political situation.

Basically, health-care reform is pretty much dead, and all that's walking around now is its zombies.

"I am wondering if now we're really off health care and on to political survival. In the last couple of months, the advocates of this plan broke cardinal rule of negotiation #2. (They broke cardinal rule #1 up front when they began negotiations with their base minimum acceptable position.) Cardinal rule #2 is: never fall so in love with the deal so much that you cannot walk away from it. The public option supporters got so invested in it that they either failed to notice or at the very least failed to speak up as their baby lost all the attributes that made it potentially cost saving, a viable alternative to expensive private plans and perhaps a good temporary compromise solution. Now that it's about as far from the original idea as it can get and survive, its advocates might just have to stick with it or go down in a serious defeat, taking many Democrats along with them...."

In a way, I almost wish that McCain and Palin had won. At least then I wouldn't be feeling betrayed, and their administration would have been pretty funny to watch. And you know they say that laughter is the best medicine....

Wednesday, July 15, 2009

"With popular fury at the status quo rising and hunger for a real, public option attracting over 70 percent approval in polls, the White House is urging public-option advocates to hush.

"According to the Washington Post, in a pre-holiday call with half a dozen top House and Senate Democrats, Obama asked health care advocates to ratchet back their pressure for a public option. He's apparently concerned about advertisements and on-line campaigns targeting foot-dragging Democrats....

"When Max Baucus, chairman of the Senate Finance Committee, sat down with health-care lobbyists on June 10, two were his former chiefs of staff. Their aim: to minimize the "damage" in profits to insurers, hospitals and drug makers from any change in approach from government. Specifically, they oppose any even remotely public option, the details of which are right now up for debate."

Mr. President, you ought to be leading the charge, not telling people to hush! The Democratic Party is in the best position it can possibly be in to bring about meaningful health-care reform and it looks like you're going to blow it, for no better reasons than fear of offending Republicans and cutting into the profits of health insurers.

The administration's Democratic partners in Congress hinted they would not deliver legislation before leaving town for an August recess. Sen. Debbie Stabenow, D-Mich., said Obama should be pleased with lawmakers' progress; Sen. Kent Conrad, D-N.D., said "there really is plenty of time."

Sunday, July 12, 2009

In this video, former health insurance industry executive Wendell Potter, who left the field after almost 20 years to become a health reform advocate, talks to Bill Moyers about what caused him to leave his highly paid job.

My first thought, hearing him describe the "health care exposition" he went to, in which uninsured people lined up to be treated in animal stalls, was to wish such events happened in Chicago.

Thursday, July 2, 2009

To highlight the hardships that plague the uninsured, Chicago docter Ogan Gurel is taking their stories to Washington, D.C. — on foot.

Gurel is adjunct associate professor of bioengineering/bioinformatics at the University of Illinois-Chicago, and chairman of Aesis Group, a medical consulting firm. As a self-employed consultant, the doctor, like nearly 50 million other Americans, lacks health insurance. Inspired by the 167-mile walk around Illinois that Pat Quinn (now governor of Illinois) and Physicians for a National Health Program founder Dr. Quentin Young took in August 2001 to promote health care for everyone, Gurel is on a one-man march to the nation's capital.

On Saturday, June 27, he left from Daley Plaza on a nearly 700-mile hike. He expects to arrive in Washington on July 27. En route, he plans to meet people and share their health-care stories through his blog, Facebook and Twitter.

In his walk, which Gurel says is nonpolitical, he isn't advocating any particular reform policy, he says. That's a pity, because it makes his walk less meaningful. It's clear that some kind of health-care reform will happen. Yet unless we have, at a minimum, a strong public option, it will fall far short of health care for all.

Monday, June 29, 2009

Why isn't Congress listening to Americans on health-care reform? This is why.

Health care interests have spent $1.4 million per day this year lobbying Congress, according to Common Cause. Just imagine if that money were spent on health care for the uninsured instead.

Common Cause also reports:

Health industries — including health insurance, pharmaceuticals and health products, hospitals and HMOs, and health professionals — have contributed over $372 million in campaign contributions to members of Congress since 2000.

Political spending by the health industries has increased 73 percent since 2000. Health interests contributed about $94 million to candidates for Congress in the 2008 election cycle, up from about $54 million in the 2000 cycle.

Members serving on committees and subcommittees with jurisdiction over health care reform in the House and Senate received the lion's share of health industries' largesse. Committee members raised $178 million from the industries this decade — roughly half of the industries' contributions to the entire Congress.

"Flowers said she plans to be in Carbondale next week to discuss the legislation and get feedback from citizens who want to 'make their voice heard' on health care. She will host a hearing at 7 p.m. June 25 at the Carbondale Civic Center.

"'The average family is paying $6,700 a year for health care in Illinois and guess what? They are not better for it, and they are not healthier for it,' she said. 'Other countries pay less, get more and live longer.'"

Saturday, June 20, 2009

So reports Forbes, which notes that Dr. David Scheiner, the Hyde Park physician who was Obama's internist from 1987 until after the election, is critical of the president's stance on health-care reform.

Forbes, naturally, tried to put as right-wing a spin on Scheiner's criticisms as possible ("Obama's Doctor Knocks ObamaCare"), but what it comes down to is that Scheiner supports single-payer health care.

"'He doesn't see all the pain, it's so tragic out here,' [Scheiner] says. 'Obama's wonderful, but on this one I'm not sure if he's getting the right input.'

"What should the president be focused on? Scheiner thinks that a good health reform would be 'Medicare for all,' a single-payer system where the government would cover everyone and pay for it by cutting out waste in the system. 'A neurosurgeon gets paid $20,000 for cutting into the neck of my patient. Have him get paid $1 million a year instead of $2 million or $3 million. He won't starve,' Scheiner says.

"Scheiner thinks that Obama's 'public plan' reform doesn't go far enough. He supports the idea of that option for people who don't like or can't afford their HMO. But he worries that it will be watered down or not happen at all. "'It's nonsense that the private insurance companies need to be protected,' he says. 'Why? Because they've done such a good job?'

Scheiner actually says he didn't discuss health policy with Obama, but it seems unlikely the latter was unaware of his doctor's views. Scheiner's medical partner, Dr. Quentin Young, founded Physicians for for a National Health Program.

Dr. Scheiner, it's not too late to write your patient a prescription for fixing health-care's ills.

Friday, June 19, 2009

Sorry if you've seen this already. I don't have cable, so I see these things when they come around on YouTube. Bill Maher is absolutely right here. Pres. "Go with the Flow" Obama is not giving us the leadership we expected or deserve.

The way he and the Democrats in Congress are kowtowing to the GOP in the name of a useless bipartisanship is a crying shame. Now is not the time to turn the other cheek and try to prove how much better your manners are than the Republicans'. Too many lives are on the line. Use your power while you have it.

We should all stop basking in the relief that Bush is gone, and push Obama into doing the things we need him to do.

Stop making nice, Mr. President. Fight for us. History will judge you on what you achieve, not on how you look on TV.

Wednesday, June 17, 2009

Ill and Uninsured in Illinois has gotten a tiny bit of recognition lately. The blog was accepted to Blogburst, a blog syndication service, which means a couple of my posts appeared on the Chicago Sun-Times' and Daily Southtown Web site. (This seems to have generated about five click-throughs to the actual blog so far, and there's no compensation, in case you were wondering.) More gratifyingly, Duncan Cross very kindly invited me to participate in the very first Patients for a Moment, a new patient-centered blog carnival, which launched today. It's a fine start. Go take a look.

One of the linked posts that particularly struck me was at Getting Closer to Myself on how to talk about one's illness. This is something I've been struggling with; most of my friends and acquaintances have no idea how sick I've been — what they think about why I've dropped out of sight I don't know. Probably they don't much care. I haven't told many people, in part because I still have hopes of finding a job when I get through all of this, and a reputation as a sickly person in the relatively small circle of my field will be hard to overcome. I never expected to be so ill for so long.

Duncan's comments, which linked my post on retail clinics to a thoughtful post from A Blessed Mess on the financial problems of chronic illness, sent me to look up just what chronic illness is.

I hadn't before now thought of myself as chronically ill. However, since the U.S. National Center for Health Statistics defines a chronic illness as one lasting three months or more, and this bout of decrepitude has lasted since late December, I guess I am. But it's the health-care system that's made me a chronic invalid.

Five years ago, when I had health insurance, I had an episode. It lasted a few weeks — four, maybe six altogether — during which time I had an emergency room visit, a follow-up with a specialist, three outpatient medical procedures and a number of intervening doctor visits. I had to take about a week off work, all told. And then it was all over and I was fine.

This new episode, without insurance, has been pretty much the same, treatment-wise. But the timing has been much different. I became ill in late December. I didn't get to see a specialist until late March. I had the first procedure in late April, with follow-up a month after that. A second procedure took place early this month, and my follow-up isn't until the end of the month. I'm guessing a third procedure will be needed, just like last time, so that'll be another two months. For all of this time, I've been too ill to leave my house, and for much of it, too sick even to work at home. I need a job, and yet I'm in no condition to look for work.

This isn't the fault of the beleaguered Cook County Health and Hospitals System. It isn't my fault. This is America's fault.

Thanks, Duncan, and also thank you to the bloggers who've added me to their blogrolls. Meanwhile, I invite your comments on this blog and suggestions on what I might do to get the word out further. By the way, please note the little star and the green doodad below. The star lets you promote a post on The Windy Citizen, Chicago's version of Digg. The green Share This icon makes it easy to share on Digg, Facebook or a variety of other social networks.

"Almost 30 key lawmakers helping draft landmark health-care legislation have financial holdings in the industry, totaling nearly $11 million worth of personal investments in a sector that could be dramatically reshaped by this summer's debate.... Their total health-care holdings could be worth $27 million, because congressional financial disclosure forms released yesterday require reporting of only broad ranges of holdings rather than precise values of assets."

Do they really think we're so dumb as to believe that people with such investments in the status quo will vote fairly on reform? And over and above that, of course, are millions in direct donations from insurers and pharmaceutical companies and their PACs accepted by Sen. Max Baucus (D-Mont.) and other key players in the heath-care reform debate. Plus other close relationships, such as the wife of Sen. Chris Dodd (D-Conn.), who, the Post points out, has remunerative positions on the boards of four health-care companies.

Sunday, June 14, 2009

Sen. Chris Dodd's health-reform site, now apparently closed after 26,363 votes on 514 entries from 484 people, got a lot of traffic from members of so-called Christian health ministries, who were apparently coached to post repeating messages (they all used nearly the same language) calling for preserving their private health-care expense-sharing plans and to hell with the rest of us. (I guess we're destined to go there, anyway, in their view, so they don't mind if we suffer here on earth first.)

Typically, the organization publishes a newsletter specifying named individuals' health-care needs every month, and members, who are required to tithe a specified amount monthly, send their donations directly to the sick person of their choice. So not only do you have to tell all your fellow members about your hemorrhoids or prostate trouble, if you're unpopular, I guess you die.

"Whether anyone chooses to pay your medical bills will be totally voluntary. This publication should never be considered as a substitute for an insurance policy. Whether you receive any payment for medical expenses, or whether or not this publication continues to operate, you will always remain liable for any unpaid bills.

"This is not a legally binding agreement to reimburse you for medical expenses you incur...."

To participate in Samaritan Ministries, you must be certified by the pastor of your church as a born-again Christian who attends church three out of every four weeks, and who doesn't drink, smoke or have sex outside of heterosexual marriage. You must also practice undefined "good health measures."

No expense under $300 is covered; payments cap out at $100,000 per illness. No preventative medicine, regular checkups or routine tests, such as colonoscopy. No chiropractic or osteopathic treatments. No treatment for mental illness or resulting suicide attempts.

If you have cancer, diabetes or a heart condition before you join, no expenses related to those conditions will be paid for, ever. A 12-month symptom- and treatment-free period applies to other pre-existing conditions. They also won't cover any sexually transmitted diseases contracted by, er, having sex.

They do, however, cover the expenses of birthing lots of Christian babies.

This time out, it's a wide-ranging compendium of views on health-care reform, including my own post on retail clinics, which author Joe Paduda links in a flattering way to the eloquent DrRich's discourse on the death of the primary care physician.

I particularly like Paduda's own solution for reform, which goes further than any proposal being considered in Washington now — not "Medicare for All" but Veterans Administration health care for all. Paduda does a good job of refuting the anti-reformers' assertion that the government can't do anything right (which, oddly enough, seems to be promulgated largely by people who were staunch supporters of the government for the past eight years).

Monday, June 8, 2009

Following health-care reform has made me realize that I don't know as much as I ought to about how my state government works, not when you get down to the nitty-gritty details.

As an excuse, I grew up in another state, so I learned something else when seventh-graders in Illinois learned that stuff, and I haven't had much call to study the state's legislature's detailed workings till now. I used to get all I needed to know from the newspapers, but our local papers no longer seem to employ reporters to cover the daily happenings in Springfield, and the principal news source about the state Capitol is a paid-subscription blog. So I've just been trying to track what I can through the state Web site.

As best as I've been able to determine, here is the status of the various health-care bills that came up in the 96th Illinois General Assembly, now recessed.

What passed

Illinois H.B. 3923, Insurance Rate FairnessRequires insurance companies to spend atleast 75 percent of premium dollars on medical care rather than on executives' salaries, marketing and profits; establishes an Office of Consumer Health Insurance to conduct reviews of claims and rate increases; streamlines application process with a standard form for individuals and small groups. Passed the House and Senate in different forms. Final action deadline extended till Nov. 30, 2009, so it could still fall apart.

Illinois S.B. 1331 and Illinois H.B. 1801, Family and Employers Health Care ActA program to make health insurance plans and HMOs affordable and accessible to small employers and individuals. Died after second reading.

For those of you who also need a primer on Illinois government, here's a guide. What's not very clear to me is what causes a bill that's gotten to a second reading to fizzle before it comes to a third reading and final vote. I'm also unsure of what may and may not be reintroduced in the fall session, but e-mail from my state rep. said it was possible H.B. 311 might return then. I hope so.

I suppose we should be urging our representatives and senators to get it together over H.B. 3923, but I can't get too excited over it. The insurance companies will find a way to finagle it somehow.

Frankly, I'm very unhappy with what my legislators have managed to achieve this session, and I don't see the furor over Blagojevich as any excuse.

Sunday, June 7, 2009

UPDATE: After commentary from 484 people, Sen. Dodd has stopped accepting opinions at the YouTube SenateHub site. You can still contact him through more traditional means.

Sen. Chris Dodd (D-CT), a senior member of the Senate Health, Education, Labor and Pensions Committee, invites you to submit your ideas and vote up or down those of others here.

I wonder whether anyone will actually pay attention to this, or whether it's just a political ploy.

Dodd asserts: "Many people like what they have. They don't want to change. They don't want us fooling around with it. And certainly our intention is if you like what you've got, then you keep what you've got."

Yet I've read every one of the 153 ideas that are there as I write, and by far the vast majority are calling for change, and most of those want single-payer.

Anyone who's had any serious illness and had to deal with the denials, the paperwork, the expense and lack of coverage entailed in the private-insurance system doesn't want to keep what they have. Those of us who don't have coverage don't want to keep what we have.

The only people who want to keep what they have are healthy people who haven't had any real interaction with their insurance companies. And, of course, people who work for insurance companies.

Saturday, June 6, 2009

I haven't written about my own situation in a while. Partly because I find writing about myself difficult, especially when there's no good news to report. This week I have good news and bad news.

The good news is that treatment is progressing. Slowly, but it's happening. The bad news is that I now have another ailment on top of the one I started with, and although I got some treatment for that, too, I feel worse. I'm frightened and discouraged, both by my own deteriorating condition and by the fact that health-care "reform" seems to be progressing in ominous ways.

Among other discouraging things that's happened lately is a conversation I had when I was at Stroger Hospital last week, being prepped for treatment. During a lull in the proceedings, I said to the anesthesiologist, "So what do you think about single-payer health care?"

"I never heard of it," she said.

I thought maybe she just wasn't familiar with the term itself and explained. "Oh, socialized medicine," she said. No, I said, and explained further. "I'll have to look into it."

Friday, June 5, 2009

Of all my nightmares over health care, the one I never thought would come to pass is a system worse than we have now. Yet it's looming on the horizon: A system in which everyone is forced to buy health insurance from the big, greedy insurance companies who continue to practice their current deceitful schemes to get out of actually providing coverage. And if you don't pay, you either face fines, or have to fill out a lot of humiliating paperwork detailing your impoverished state in order to qualify for the privilege of doing without decent health care.

That's the plan being considered by senators Max Baucus and Edward Kennedy and, yes, Pres. Barack Obama. And they call themselves Democrats?

Thursday, June 4, 2009

UPDATE: I unfairly maligned Walgreens' nurse-practitioner for not doing any tests; in subsequent research I learned that my new illness is best diagnosed clinically in its early stages. On the other hand, the dosage of antibiotics she prescribed was too little, as I found out when I phoned my doctor. He told me to take the pills twice as often and twice as long, and graciously phoned in another prescription, so I was spared the price of an office visit. However, he said that if that doesn't clear up the symptoms, I will need to see a specialist.

(AP) — "Walk-in retail clinics in grocery and drugstore chains can help the uninsured find health care, proponents say. But a new study suggests most retail clinics aren't in the poorest neighborhoods.

"Like most businesses, they go where the money is — to more affluent neighborhoods, which already happen to be well-served by other medical resources....

"The study's results suggest financial incentives may be needed to lure the clinics to low-income neighborhoods, said study author Dr. Craig Pollack of the University of Pennsylvania....

"Open late and on weekends, the clinics use nurse practitioners to give shots and treat minor ailments such as sore throats and rashes. Visits typically cost $40 to $75, and prices are posted so consumers know what they're paying. People pay cash or use insurance....

"Industry leaders said retail clinics were designed to offer convenient care, not as the health care system's safety net. But they play a role, industry officials acknowledge. The clinics' own research shows 30 to 40 percent of patients say they don't have a primary care provider, said Tine Hansen-Turton of the Convenient Care Association, a trade group representing most of the clinics...."

Retail clinics like Walgreens' Take Care are quick and convenient. They're open evenings and weekends, and you don't need an appointment. If you don't have insurance, they're somewhat less expensive than a visit to most doctors.

Under our present health-care system, they do have a role. But they're a stop-gap, not a replacement for a primary-care physician. If you catch the flu or sprain your ankle on the weekend, they can save you a trip to the emergency room. But if your flu turns into pneumonia, or the ankle remains weak and needs physical therapy, they won't offer you followup care. For that matter, they can't x-ray your ankle to see if it's actually broken. If you have a chronic condition that needs monitoring, they don't do that, either.

* * *

Recently, I visited a Take Care clinic because of an illness I self-diagnosed ... with help from Dr. Google. Dr. G told me that it's one of those things that can get very bad if left untreated, so I thought I'd better get checked out. I didn't want to go to the Stroger Hospital emergency room, and the retail clinic seemed like the least expensive alternative.

The nurse-practitioner took a short medical history, did a very brief exam, listened to my description of my symptoms, said it looked as if I was right, and prescribed antibiotics. It cost $68.

She did no tests. She had to look up the correct antibiotic in a book. I asked about followup care, and she advised me to see a regular doctor once I'd finished the medication.

If Dr. Google and Take Care's APN are right, the pills will likely help me. If they're wrong, I'll have had — at a minimum — an unnecessary course of antibiotics that will do me no good.

Would my treatment have been different had I gone to the doctor I used to see when I had insurance? Perhaps not. But I bet he'd have ordered a test before writing a scrip, and I'd know for certain whether I had the disease I feared, or something else.

Of course, his price would have been higher, too.

* * *

Even for the limited ailments and injuries they diagnose and treat, retail clinics aren't a substitute for having a regular doctor who knows you and your history. If you rely on on such clinics for your medical care, it's very possible that underlying problems will go on unrecognized. And, as this new study notes, they aren't even convenient for the people who most need health care options.

To me, the existence of these clinics is just another symptom of our spotty, patchwork health-care system. Rather than offer financial incentives to create more for-profit retail health clinics in poor, underserved areas, it makes more sense to set up nonprofit or government-run clinics and offer incentives to doctors to work there.

Why don't we have a medical version of ROTC in the United States? In Australia, government scholarships subsidize the training of medical students who agree to spend six years working in underserved areas once they complete their schooling.

Somehow, it seems typical of the state of America now that our government trains young people to make war, but not health care.

June 25: Great American Sickout, National Rally for Health Care for All Now. Those who can, gather at 10 a.m. at the Washington Monument on the National Mall in Washington, D.C. Those who can't, stay home from work and call the White House and all your representatives and senators.

Pres. Obama will join confirmed hosts and attendees in a live conference call. Some 50 events are already planned for the Chicago area. The Web site lets sign up to host or attend a kickoff function, and provides scripts for how it should go.

The kickoffs are intended to organize a June 27 National Health Care Day of Service and to promote Obama's three key health reform principles:

Reduce rising health-care costs

Guarantee choice in keeping or finding a new doctor or insurance

Ensure affordable care for all

It's No. 2 that's the hitch, since by "choice" the administration means your choice to preserve the greedy, corrupt health-insurance companies that are enriching Congress at the expense of Americans' health. It defeats the other two principles.

I don't like that choice. The 50 million of us who are uninsured don't have any health-care choices right now. The millions more who are stuck with whatever plan their employer offers don't have any choice. The people who can't change jobs because they'll lose coverage of their pre-existing conditions don't have a choice, either.

We don't need choice. We need health care!

Yet I definitely think single-payer advocates should sign up to host and attend these organizing events. Just rewrite the script!

Use this as an opportunity to point out that before Washington's sacred cash cows got to him, Pres. Obama was an advocate for single payer universal health care. "That's what I'd like to see," he said. "We may not get immediately, because we've got to take back the White House. We've got to take back the Senate. We've got to take back the House."

Point out that we've done all of those things, now, so it's time to take back health care, too.

The newer batch of pictures comes from the vacant old Cook County Hospital structure, in the Illinois Medical District near its replacement, Stroger Hospital. The hospital achieved national fame as the inspiration for the County General of the fictional TV series, ER.

I'm not sure of the current status of this building. It was slated for demolition some years ago, and remains on the National Trust for Historic Preservation's list of endangered places.

The land is valuable, and the Classical Revival exterior beautiful, with all that glazed terra cotta ornamentation. Nobody builds hospitals like that anymore. None of the proposals I've seen for rehabbing the structure involve health-care uses.

It's disturbing that the photographer and his friends were able to gain access so easily. As he documents in the blog and the accompanying Flickr stream, parts of the interior were still in fairly good condition in 2008. A few squatters or vandals could do untold amounts of damage. I'm wondering if the cash-strapped county ever called in an architectural salvage firm for bids. Some of the abandoned elements might have value, or at least they would have when the hospital closed seven years ago.

The earlier series is even more disturbing, however. It shows Edgewater Medical Center, birthplace of John Wayne Gacy and Hillary Rodham Clinton, which was shuttered in 2001 after members of its management and medical staff were convicted of massive Medicare fraud. When the building was abandoned, its patients' medical records were apparently just left behind.

Saturday, May 30, 2009

When Barack Obama promised "change," I didn't realize he meant the kind that goes ka-ching ... in the pockets of politicians.

Yet he's done absolutely nothing to resist the influence of monied lobbyists on Washington. I suppose that's too much to ask of an Illinois pol.

First, all the bailouts that paid insurance executives bonuses and let them go on luxury retreats. Now, a retreat from real health-care reform.

Now that he's the seat of all the money and power in Washington, Obama has turned away from the health-reform goals he once told us he believed in. He's barely involved himself personally in the debate, instead turning the crafting of health-care policy over to Sen. Max BauCASH, who's clearly been paid for by Big Medicine and the insurance industry, and he's tolerated the almost complete silencing of advocates for single-payer.

That's wrong. Maybe Congress is so venal that nothing we can say will make them vote for what's best for America's health; maybe they're all bought and paid for. I don't know. But not to permit open speech on the subject, not to let people who represent the opinions of millions of Americans speak on the same platforms as the profiteers who have sickened both our health and our economy, that's criminal.

Far more criminal than the valiant doctors and nurses BauCASH had hauled off to jail for trying to have their say.

Now, Obama says, mealymouthed: "If I were starting a system from scratch then I think that the idea of moving toward a single-payer system could very well make sense. That's the kind of system that you have in most industrialized countries around the world. The only problem is that we're not starting from scratch."

Americans need to let our president know that we won't stand for this. We need to shout — and keep shouting — that we want the single-payer, universal health care that Obama promised us back when he was a state senator — if only we could take back the White House, the Senate and the House. Well, we've done that for him.

As for starting from scratch, isn't that what change is supposed to be about?

SPEAKERS FROM: Chicago Single-Payer Action Network, California Nurses Association and Physicians for a National Health Program

The crisis in health care is worse than ever. Millions of people have lost their jobs and with it health insurance because of the economic crisis. Now over 50 million have no health insurance. The Institute of Medicine estimates that 22,000 die every year due to lack of access to health care.

President Obama and Senator Max Baucus have excluded the voices of single-payer supporters in the national discussion on health care reform. They said a single-payer system is "off the table" but then say all viewpoints are being heard in Washington. That's why 8 doctors disrupted a recent senate hearing on health care reform and demanded advocates of single-payer be at the table.

The majority of people and doctors in the this country want single-payer, a government financed system that gets rid of the private insurance industry once and for all.

Join us in a national day of action to raise our voices in support of single-payer.

Wednesday, May 27, 2009

Health Care for America Now!'s Illinois chapter struggles with blogging. First, they forgot to turn off the default list of Wordpress links; then, they had a variety of formatting troubles. They post infrequently. They have yet to figure out how to use categories or tags, and currently when you try to leave a comment, the blog reports: "ERROR: It looks like the website administrator hasn't activated the Brians Threaded Comments plugin from the plugin page."

Since I have twice e-mailed them in the past with bug reports and offers to help and haven't received so much as an acknowledgment, I'm not going to bother again.

The post I was trying to reply to is of interest, however. As you may know, one of the stupid ideas floating around Washington right now is a proposal for a "trigger" that would only put a public insurance option in place if competition among private insurance companies drops below a set level. HCAN has a new report showing that we already lack competition in the Illinois health insurance marketplace, leading to skyrocketing premiums for both patients and employers.

"The report shows how a handful of private health insurance companies have built a near-monopoly in the Illinois market, burdening families and businesses with premiums that grew 5.6 times faster than wages from 2000 to 2007. Illinois' two largest health insurers control 67% share of the market. Under a competition rating system used by the U.S. Justice Department, the Illinois market is "concentrated." The local markets are even worse for Rockford (82%), Bloomington-Normal (87%), and Champaign-Urbana (83%) where the US Justice Department considers these local markets 'highly concentrated.'"

HCAN-IL has unfortunately headed this with the title, "New Report Details Need for Competition in Illinois Health Insurance Market," which is not only boring, but also a wrong-headed conclusion. (HCAN, though right in their condemnation of the insurance industry's foul business practices, is cowardly in their proposals for reform. They believe the public option is the best we can hope for, and they don't think one's reach ought to exceed one's grasp.)

Here's the reply I'd have made if they'd had their comments working:

While I'm sure your data is correct, I disagree with your conclusions. What your report indicates is a need to do away with private insurance altogether, and replace it with a cost-effective, comprehensive, single-payer system that avoids the layers of waste and profiteering implicit in the health-insurance industry.

The public option plan is already a weak compromise, not real health reform, and the "trigger" is an abysmal idea that will continue to stop Americans from getting health care.

Monday, May 18, 2009

Over at The Covert Rationing Blog, the eccentric DrRich, who likes to refer to himself in the third person, takes a backwards look at the failed health-reform efforts of the Clinton administration, explains why things are different today, and gleefully contemplates the idea that the Obama team may find themselves confronting the R word.

So?

I'm not old enough to have lived through rationing in this country, but I've done a lot of reading, and I don't exactly understand why rationing is such a dirty word, even when applied to health care. It's not something for those of us who aren't insured now to worry about, because any health-care system that formalized rationing would give us more than we're getting now. Some 22,000 of us die each year for no good reason.

If rationing means that more of the terminally ill die with dignity, instead of being subjected to futile extreme measures so their families can quell their consciences, I have no qualms. If it means that, instead of getting elective surgery on demand, some people have to wait a little while, I'm unsympathetic. The poor and the uninsured are waiting much longer now.

As for those who can now buy whatever kind of health care they desire, well, surely no one is naive enough to believe that reforms will stop the rich from getting what they want. Where there is rationing, there are black markets.

No matter what happens in health reform, I assume there will continue to be exclusive private clinics where the wealthy can have their tummies tucked and their boobs lifted, and no doubt some of them will branch out to other services if there's money in it. Medical tourism will continue to boom, too. The rich will always get all the medical treatment they demand, just as they do even in countries with full-blown socialized medicine (a system that no one here is seriously advocating).

And what of the middle-class — that portion of them, anyway, who've managed to hang on to their jobs and benefits? How will reform — with, perhaps, the dreaded rationing — affect them?

Thursday, May 14, 2009

Do No Harm, a documentary about the struggle, against relentless attacks, of two reluctant Georgia whistleblowers to draw national attention to hospital corruption and the plight of the uninsured, gets its Chicago premiere Thursday, May 21, at the Museum of Contemporary Art, 220 E. Chicago Ave., Chicago.

The event opens at 6 p.m. with a reception at Puck's at the MCA. Illinois Attorney General Lisa Madigan will introduce the film. After the screening, a panel discussion will feature Dr. Quentin Young, founder of Physicians for a National Health Program and an advocate for single-payer health care; Mark Rukavina, executive director of The Access Project, whose research has uncovered unfair hospital billing and collection issues; and Donna Smith, founder of American Patients United, an organization whose members believe access to quality health care is a human right.

The film focuses on Phoebe Putney, a nonprofit hospital in Albany, Ga. In 2003, Dr. John Bagnato and accountant Charles Rehberg stumbled on evidence that the hospital overcharged uninsured and indigent patients, using aggressive collections tactics to recover costs. Investigation showed, that despite receiving huge tax breaks, the hospital held millions of dollars in offshore bank accounts and for-profit businesses under its control — and the same went for nonprofit hospitals across the country, while providing minimal charity care. (In other cases, Urbana's Provena Covenant Medical Center lost its tax-exempt status, and the Chicago-area's Advocate Health Care and Resurrection Health Care networks were the subject of class-action lawsuits.)

When they made their discoveries public, Bagnato and Rehberg became the targets of threats and intimidation.

Monday, May 11, 2009

When I spent 11 hours in the waiting room of Stroger Hospital's emergency department, it was December. The elections were not long over, and many of my fellow patients, waiting so stoically for treatment during the long hours, still sported hats, buttons and other paraphernalia from the campaign. As you might guess, no one needing care at the county hospital was promoting McCain.

Last week, I was at Stroger again, this time for a long-awaited visit to a specialty clinic. I'll save the details for another time, but as I waited there — I noticed that a few other patients were still wearing Obama 2008 gear. Now, when you're sick and standing in in a long, slow line outside a laboratory, waiting your turn to have blood drawn and pee in a cup, it's not the best time to engage in political discussion, but I tried to talk about health reform a little.